title: Risk factors for early and late intrahepatic recurrence in patients with single hepatocellular carcinoma without macrovascular invasion after curative resection.
abstract: BACKGROUND
  Prognostic factors of postoperative early and late recurrence in patients with hepatocellular carcinoma (HCC) undergoing curative resection remain to be clarified. The aim of this study was to identify risk factors for postoperative early (≤ 2 year) and late (> 2 year) intrahepatic recurrences in patients with single HCCs without macrovascular invasion.
  
  
  METHODS
  A total of 280 patients from December 2004 to December 2007 were retrospectively included in this study. Intrahepatic recurrence was classified into early (≤ 2 year) and late (> 2 year) and the Chi-Square test or Fisher's exact test and multivariate logistic regression analysis were performed to determine significant risk factors.
  
  
  RESULTS
  During the follow-up, 124 patients had intrahepatic recurrence, early and late in 82 and 42 patients, respectively. Multivariate logistic regression analysis showed that microvascular invasion (p=0.006, HR: 2.397, 95% CI: 1.290-4.451) was the only independent risk factor for early recurrence, while being female (p = 0.031, HR: 0.326, 95% CI: 0.118-0.901), and having a high degree of cirrhosis (P=0.001, HR: 2.483, 95% CI: 1.417-4.349) were independent risk factors for late recurrence.
  
  
  CONCLUSIONS
  Early and late recurrence of HCC is linked to different risk factors in patients with single HCC without macrovascular invasion. This results suggested different emphases of strategies for prevent of recurrence after curative resection, more active intervention including adjuvant therapy, anti-cirrhosis drugs and careful follow-up being necessary for patients with relevant risk factors.
authors.affiliation: Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, China E-mail : guorp@sysucc.org.cn.
authors.forename: Shu-Hong
authors.initials: SH
authors.lastname: Li
authors.forename: Zhi-Xing
authors.initials: ZX
authors.lastname: Guo
authors.forename: Cheng-Zuo
authors.initials: CZ
authors.lastname: Xiao
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Ming
authors.initials: M
authors.lastname: Shi
authors.forename: Zhi-Yuan
authors.initials: ZY
authors.lastname: Chen
authors.forename: Mu-Yan
authors.initials: MY
authors.lastname: Cai
authors.forename: Lie
authors.initials: L
authors.lastname: Zheng
authors.forename: Rong-Ping
authors.initials: RP
authors.lastname: Guo
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology*; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors